Individual provider Active NPI

Margaret Law Glissmeyer, PA-C

  • Medical Physician Assistant
  • Tacoma, WA
National Provider Identifier
1669402962
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60558414 Issued in WA
Practice address
1112 6TH Ave Ste 200
Tacoma, WA 98405-4048
Phone
(253) 272-8664
Fax
(206) 835-7439
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MG1163461 OR
Medical Physician Assistant 363AM0700X PA60558414 WA Primary

Addresses

Primary practice location

1112 6TH Ave Ste 200
Tacoma, WA 98405-4048

Mailing address

1112 6TH Ave Ste 200
Tacoma, WA 98405-4048
Phone (253) 272-8664

Other identifiers 2

IdentifierTypeStateIssuer
1055011MedicaidWA
044532MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mglissmeyer451497@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190221002706 WA Practitioner - Physician Assistant 1759391410 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Childrens Hospital CurrentSince Jun 16, 2020 Accepting new patients
Seattle Children'S Hospital CurrentSince Jun 16, 2020 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Franciscan Medical Group Past Accepting new patients
Surgical Associats, PC PastSince Jun 16, 2014 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: mglissmeyer451497@fhsce.catholichealth.net
  • Direct secure messaging: mglissmeyer89483@direct.seattlechildrens.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1669402962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 6TH AVE STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054048",
            "telephone_number": "253-272-8664",
            "fax_number": "206-835-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 6TH AVE STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054048",
            "telephone_number": "253-272-8664",
            "fax_number": "206-835-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLISSMEYER",
        "first_name": "MARGARET",
        "middle_name": "LAW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "MG1163461",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60558414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1055011",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044532",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mglissmeyer451497@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1112 6th Ave Ste 200",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.